Provider Demographics
NPI:1891179214
Name:NORTH FLORIDA PRIMARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORTH FLORIDA PRIMARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:LALCHETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-222-6176
Mailing Address - Street 1:12620 BEACH BLVD
Mailing Address - Street 2:STE 3#155
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-7131
Mailing Address - Country:US
Mailing Address - Phone:904-222-6176
Mailing Address - Fax:904-425-7857
Practice Address - Street 1:10175 FORTUNE PKWY
Practice Address - Street 2:SUITE 802
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6746
Practice Address - Country:US
Practice Address - Phone:904-222-6176
Practice Address - Fax:904-425-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIH820AMedicare PIN